Provider Demographics
NPI:1144936048
Name:THOMPSON, ANTHONY SCOTT (RN)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:SCOTT
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 OASIS WAY # 21-411
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2278
Mailing Address - Country:US
Mailing Address - Phone:508-562-7399
Mailing Address - Fax:
Practice Address - Street 1:77 STATE RD STE 1R
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2935
Practice Address - Country:US
Practice Address - Phone:774-202-6963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN251937363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse